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HAVE you ever burst into laughter at a highly inopportune moment – in a business meeting, say, or at a funeral? If you have, you’ll know a bit about what it feels like to suffer from emotional incontinence.

It really is no laughing matter. Emotional incontinence, also known as Pseudobulbar Affect or pathological laughter, is a genuine medical condition that causes uncontrollable bouts of laughter completely divorced from any joyful emotion, a kind of neurological muscle spasm. The medical profession has at last begun to take sufferers seriously, and a US pharmaceutical company has just developed a drug to tame the twitch.

Who suffers from emotional incontinence? Usually, it is associated with a more serious neurological disease such as amyotrophic lateral sclerosis or Parkinson’s. In addition to laughter, the condition often subjects sufferers to fits of uncontrollable crying, and some have outbursts of anger and rage. It has also been linked to another condition called Witzelsucht, sufferers from which show an uncontrollable tendency to pun, make bad jokes and tell meaningless stories at inappropriate moments.

What causes such outlandish emotional exhibitionism? We still know very little, although lesions in the brain appear to trigger it. These lesions damage motor neurons, which are responsible for relaying messages from the brain to various muscles. Emotional incontinence offers an intriguing peek into the relationship between emotional feeling and emotional behaviour, which do not seem to be inextricably linked. For example, stimulation of the hypothalamus during brain surgery has incited patients to laugh and even sing, and people have also been induced to laugh simply by electrically stimulating their left frontal cortex.

Why do we know so little? A major reason is that laughter is rarely linked to anything considered problematic. Laughter studies have tended to focus on its positive health benefits, such as increased heart rate, improved muscle tone and better circulation. But increasing awareness of the number of people who suffer from emotional incontinence, estimated at nearly a million in the US alone, has pushed it up the agenda.

Is there anything doctors can do for emotionally incontinent people? Up to now, not much. They are often prescribed antidepressants – with mixed results, as the condition is not a form of depression. The US drug company Avanir has just developed a drug called Neurodex to treat the condition head-on, though it is still awaiting approval. Meanwhile, next time you see someone collapse in a fit of giggles during a memorial service, have a bit of sympathy.